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Çelik Ekinci S, Yenilmez E, Akengin Öcal G, Sönmezer MÇ, Tarakçı A, Aygün C, Akdağ D, Seyman D, Aşık C, Zerdali E, Yılmaz Karadağ F, Kaya Ş, Çelik M, Çifci Ş, Yıldız İE, Çölkesen F, Akgül F, Aldemir Ö, Bozdağ M, Özer D, Hızmalı L, Canbolat Ünlü E, Gür Altunay D, Şahin A, Ünlü G, Gençalioğlu AE, Tekin Şahin S, Özdemir Y, Ünlü S, Singil S, Altıntaş J, Akkaya Işık S, Gül Ö, Tuna N, Şimşek S, Özgüler M, Elbir Kılıç P, Işık ME, Karakuş A, Kıratlı K, Yardımcı AC, Volkan S, Olçar Y, Çakır Y, Özer Yılmaz N, Karaayvaz S, Batırel A, Duran ZC, Raşa HK, Köse Ş. Surgical Antimicrobial Prophylaxis Compliance in Turkey: Data from the Prospective, Observational, Multicenter Survey Including 7,978 Surgical Patients. Surg Infect (Larchmt) 2024; 25:231-239. [PMID: 38588521 DOI: 10.1089/sur.2023.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Background: Surgical antimicrobial prophylaxis (SAP) is the peri-operative administration of antimicrobial agents. Compliance rates vary worldwide from 15% to 84.3%, with studies in Turkey not exceeding 35%. The aim of this multicenter study was to determine the rate of appropriate antibiotic class, timing, and duration as well as discharge prescriptions in Turkey. Thus, we aimed to determine the rate of full compliance with SAP procedures in our country Patients and Methods: This multicenter, prospective, observational, descriptive study was conducted in 47 hospitals from 28 provinces in seven different regions of Turkey. Patients over 18 years of age in all surgical units between June 6, 2022, and June 10, 2022, were included in the study. Results: Of the 7,978 patients included in the study, 332 were excluded from further analyses because of pre-existing infection, and SAP compliance analyses were performed on the remaining 7,646 cases. The antibiotic most commonly used for SAP was cefazolin (n = 4,701; 61.5%), followed by third-generation cephalosporins (n = 596; 7.8%). The most common time to start SAP was within 30 minutes before surgery (n = 2,252; 32.5%), followed by 30 to 60 minutes before surgery (n = 1,638; 23.6%). Surgical antimicrobial prophylaxis duration was <24 hours in 3,516 (50.7%) patients and prolonged until discharge in 1,505 (21.7%) patients. Finally, the actual proportion of patients compliant with SAP was 19% (n = 1,452) after omitting 4,458 (58.3%) patients who were prescribed oral antibiotic agents at discharge as part of a prolonged SAP. Conclusions: Surgical antimicrobial prophylaxis compliance rates are still very low in Turkey. Prolonged duration of SAP and especially high rate of antibiotic prescription at discharge are the main reasons for non-compliance with SAP.
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Affiliation(s)
- Semiha Çelik Ekinci
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ataşehir, İstanbul, Turkey
| | - Ercan Yenilmez
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Ataşehir, İstanbul, Turkey
| | - Gülfem Akengin Öcal
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Meliha Çağla Sönmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Arzu Tarakçı
- Department of Infectious Diseases and Clinical Microbiology, Konya City Hospital, Konya, Turkey
| | - Cemanur Aygün
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
| | - Damla Akdağ
- Department of Infectious Diseases and Clinical Microbiology, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Derya Seyman
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cansu Aşık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Fatma Yılmaz Karadağ
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Şafak Kaya
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Mehmet Çelik
- Department of Infectious Diseases and Clinical Microbiology, Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Şeyma Çifci
- Department of Infectious Diseases and Clinical Microbiology, Nevşehir State Hospital, Nevşehir, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Turkey
| | - Fatma Çölkesen
- Department of Infectious Diseases and Clinical Microbiology, Konya Numune Hospital, Konya, Turkey
| | - Fethiye Akgül
- Department of Infectious Diseases and Clinical Microbiology, Batman Training and Research Hospital, Batman, Turkey
| | - Özlem Aldemir
- Department of Infectious Diseases and Clinical Microbiology, Sivas Numune Hospital, Sivas, Turkey
| | - Merve Bozdağ
- Department of Infectious Diseases and Clinical Microbiology University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Deniz Özer
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Lokman Hızmalı
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Esra Canbolat Ünlü
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Deniz Gür Altunay
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey
| | - Ahmet Şahin
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Gülten Ünlü
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayşe Eda Gençalioğlu
- Department of Infectious Diseases and Clinical Microbiology, Trabzon Fatih State Hospital, Trabzon, Turkey
| | - Sema Tekin Şahin
- Department of Infectious Diseases and Clinical Microbiology, Alanya Training and Research Hospital, Antalya, Turkey
| | - Yeliz Özdemir
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Sibel Ünlü
- Department of Infectious Diseases and Clinical Microbiology, Mersin Toros State Hospital, Mersin, Turkey
| | - Sarp Singil
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Jale Altıntaş
- Department of Infectious Diseases and Clinical Microbiology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Sinem Akkaya Işık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Sultan 2.Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Özlem Gül
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Nazan Tuna
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Sümeyra Şimşek
- Department of Infectious Diseases and Clinical Microbiology, Çorlu State Hospital, Tekirdağ, Turkey
| | - Müge Özgüler
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Pınar Elbir Kılıç
- Department of Infectious Diseases and Clinical Microbiology, Tuzla State Hospital, İstanbul, Turkey
| | - Mehmet Emirhan Işık
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey
| | - Ayşe Karakuş
- Department of Infectious Diseases and Clinical Microbiology, Hendek State Hospital, Sakarya, Turkey
| | - Kazım Kıratlı
- Department of Infectious Diseases and Clinical Microbiology, Katip Çelebi University, İzmir Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ahmet Cem Yardımcı
- Department of Infectious Diseases and Clinical Microbiology, VM Medical Park Mersin Hospital, Mersin, Turkey
| | - Serkan Volkan
- Department of Infectious Diseases and Clinical Microbiology, Aydın State Hospital, Aydın, Turkey
| | - Yıldız Olçar
- Department of Infectious Diseases and Clinical Microbiology, Kastamonu Training and Research Hospital, Kastamonu, Turkey
| | - Yasemin Çakır
- Department of Infectious Diseases and Clinical Microbiology, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Nermin Özer Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training And Research Hospital, İstanbul, Turkey
| | - Serhat Karaayvaz
- Department of Infectious Diseases and Clinical Microbiology, Ezine State Hospital, Çanakkale, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Zeynep Cansu Duran
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Hüseyin Kemal Raşa
- Department of General Surgery, Anadolu Medical Center Gebze, Kocaeli, Turkey
| | - Şükran Köse
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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